The concept of home health care began in the 1850's when traveling health care professionals, usually physicians, provided in-home visits to patients who were in need of health care and were unable to seek such care outside of the home. From the outset, however, traveling between various patients' homes constituted “downtime” for the health care professional. In the middle of the twentieth century, this type of medical service was transferred from the physician to nurses or other health care workers. During the past decade, providing home health care has become more difficult due to the shortage of health care professionals in general and, in particular, of those who provide home health care. Because of this shortage as well as the increase in medical costs, home health care visits may be limited to basic needs and/or medical emergencies.
On the other hand, the number of patients who are home bound has been increasing. Many terminally ill patients, such as heart failure or cancer patients among others, are sent home to live with their families who provide 24-hour care. Other patients with chronic health problems reside in their homes where they receive necessary support and treatment on an “as needed” basis. Through the auspices of hospices or other support groups, nurses or health care workers provide medical care and evaluation on a periodic basis. Although these visits provide the contracted services, nonetheless they still suffer from administrative “overload” tasks.
The nurse or other health care worker may spend much of her time on the phone, contacting physicians, druggists, plan administrators, the family members of the patient, and so on. In addition, that same nurse must take notes and/or fill out health plan or HICFA forms to ensure reimbursement for the services provided. As a result, a large percentage of the time during the visit has little to do with providing medical care and evaluation of the patient.
Patients with implantable medical devices (IMDs) also require regular checkups to determine whether their IMDs have been functioning properly. Most patients with IMDs must be monitored bi-annually, at the very least. Such monitoring may occur transtelephonically from the patient's home or via telemetry as has been disclosed in U.S. Pat. No. 5,752,976 issued to Duffin, et al, “World Wide Patient Location and Data Telemetry System for Implantable Medical Devices”, incorporated herein by reference in its totality. Still, some of the very elderly patients with IMDs, whether single or multiple, require periodic visits from health care nurses/workers to evaluate their IMD(s).
Various solutions to these issues, in addition to the '976 patent, have been suggested in the art. U.S. Pat. No. 5,553,609 issued to Chen, et al, “Intelligent Remote Visual Monitoring System for Home Health Care Service” generally discloses a computer-based remote visual monitoring system connected transtelephonically to a remote master-monitoring computer. This system is intended for use by the visiting nurse during an in-home patient health care visit. Separate audio and visual equipment facilitates communication between the patient's home and a remote station. The system has several layers, including units in the patient's home, the caregiver's office, and the supervisory control center. Audiovisual equipment in the patient's home and at the caregiver's office provides two-way communications during a home visit. There is also a provision for generating and maintaining the patient's medical records. The '609 patent, however, does not appear to teach a method for monitoring patients with IMDs. U.S. Pat. No. 5,749,908 issued to Snell, “Methods and Apparatus for Annotating Data in an Implantable Device Programmer Using Digitally Recorded Sound”, teaches a system in which data from an IMD patient may be downloaded to a programmer using digitally recorded voice signals and/or digitizer pen. A physician, upon reviewing the data, can listen to the voice annotations by using a playback mode. While the '908 patent addresses issues that are specific to patients with IMDs, it implements the use of a device programmer. Further, desirable features such as a method to address or deal with the previously cited administrative tasks, that consume so much time during a typical visit, appear to be undisclosed by the '908 patent.
U.S. Pat. No. 5,872,923 issued to Schwartz, et al, “Collaborative Video Conferencing System” discloses a video conferencing system, wherein multiple parties at different locations can view, and modify, a common image on their computer displays. The invention also provides a video camera at each computer, which takes a video picture of each party. The systems described in the '609 and '923 patents, however, appear to depend on static, non-mobile computer terminals.
What is needed to optimize the tasks for the home health care worker is a mobile device akin to a Personal Data Assistant (PDA) disclosed in U.S. Pat. No. 6,016,476, issued to Maes, et al, “Portable Information and Transaction Processing System and Method Utilizing Biometric Authorization and Digital Certificate Security” incorporated herein by reference in its totality. The PDA in this patent is a portable device with a touch screen, with a microphone and local CPU for processing voice commands and user verification. While the '476 patent is intended for managing financial data, its general concept may underlie certain aspects of the present invention. One aspect of particular interest, for example, is a method to verify the identity of the user via voice recognition. An alternative method for identifying the user is disclosed in U.S. Pat. No. 5,787,186 issued to Schroeder “Biometric Security Process for Authenticating Identity and Credit Cards, Visas, Passports and Facial Recognition” in which a person's facial structure is used to verify a person's identity. The '186 patent teaches the use of an image capturer such as a scanner or a video camera to capture facial features that are transferred to the CPI for an analysis of a basic facial image. If matched to the stored image, the user can gain entry into files containing secure data.
Inputting data may be accomplished via a digitizer pen, tethered to a PDA, as disclosed in U.S. Pat. No. 5,756,941, issued to Snell “Retractable Pen Tether for a Digitizer Pen and Method of Attaching a Digitizer Pen to a Digitizer”, incorporated herein by reference in its totality. Such a pen is intended for use in a hand-held computer and is kept in a pen storage chamber incorporated within the body of the PDA. Such digitizer pens, though not tethered to the PDA as taught by the '941 patent, are now commonly available with commercial PDAs. Such common use should make these digitizer pens an easy-to-use tool for the home health care worker.
A health care worker must often spend a good deal of time trying to determine where she must go for her next visit, especially if the next visit is a new patient. U.S. Pat. No. 6,177,905 issued to Welch “Location-Triggered reminder for Mobile User Devices”, discloses how to equip a PDA with a global positioning system (GPS) receiver. The user can program into the PDA geographical coordinates of locations and, thereafter, give them names. These names can then be called up and, by reference to one's present location, provide directions to a new location which, in this context, could be the next visit.
What is needed is a system that provides all the benefits of home health care service with methods and structures implemented to enable monitoring of IMD patients on a regular basis.